Paralysis of the femoral nerve secondary to iliopsoas haematoma is a rare post-traumatic complication. Because of the large differential diagnosis, a high level of suspicion is required for its early recognition. Treatment modalities are controversial due to the rarity of this entity. An 18-year-old student presented with complete paralysis of the knee extensors and a sensory deficit on the anterior side of the thigh 5 weeks after a sport accident. MRI of the lesser pelvis showed an iliopsoas haematoma. Surgical decompression was performed and recovery was complete at 6 months of follow-up.
Solitary osteochondromas rarely occur in the axial skeleton. Those tumors mostly arise on the posterior elements of the cervical column causing various symptoms especially when developing within the spinal canal. Exophytic lumbar variety is uncommon presenting with palpable mass or spinal deformity. We report a 20-year-old man presenting with a solid painless mass at the lower lumbar region. Radiological examinations revealed an exophytic lesion arising in the third lumbar spinous process appearing to be a solitary osteochondroma. The lesion was treated by en-bloc resection; histopathological examination confirmed the diagnosis of osteochondroma with no evidence of recurrence at the end of 2-year follow up.
Management of bone metastases from renal cell carcinoma (RCC) has significantly changed after the era of targeted therapy that improved the overall survival (OS). Surgical decision‐making remains a subject of controversy. We report a case of pelvic bone metastasis from RCC, 2 months after nephrectomy and surgery of a revealing clavicular metastasis.
Context:Brucellosis is actually considered to be the commonest zoonotic infection worldwide; conversely prosthetic infection due to brucella is extremely rare. Although diagnostic is easily achieved, management of such situations is extremely challenging.AimsTo report the case of prosthetic hip loosening due to brucellar infection, discuss management manners and to summarize data about 19 cases reported in the literature.MethodsWe report the case of a 73-year-old woman with brucellar prosthetic hip loosening treated with 2-stage exchange of the prosthesis and prolonged double antibiotherapyResultsAt two years follow up the patient is pain free with total functional recovery and no clinical and radiographic signs of prosthetic looseningConclusionsBrucella should be evocated as a cause of total joint arthroplasty infection especially in patients from endemic regions and with occupational exposure. Antibiotic treatment alone can be followed if there are no signs of implant loosening. Tow stage revision should be considered in other cases.
Abstractcontext: Prosthetic joint infection due to Mycobacterium tuberculosis (MTB) with no previous history of pulmonary or extra pulmonary tuberculosis is a rare complication.Aims: To report the case of a patient with tuberculous mycobacterial prosthetic hip infection, 14 years after surgery for post traumatic osteoarthritis, with no previous history of tuberculosis.methods: A 46-year-old male presented with acetabular loosening of a cemented total hip arthroplasty with normal biologic parameters. A one stage revision surgery was planned. Intraoperative findings suggested mycobacterial tuberculous infection with presence of periacetabular yellowish rice-shaped granules.results: A one-stage prosthesis exchange was performed; Culture on Löwenstein-Jensen medium grew MTB days after inoculation and histological examination confirmed tuberculous infection. Patient was treated with antituberculous agents for 12 months with optimal clinical and biological response and no prosthetic loosening signs at two year follow up.conclusions: Total hip arthroplasty loosening due to mycobacterium tuberculosis is a rare entity, which should be considered even when no inflammatory signs are shown. Discovery of yellowish riceshaped granules is suggestive of periprosthetic tuberculosis. Management of prosthetic joint infection due to M.tuberculosis must involve both medical and surgical therapy.
Ewing’s sarcoma of the mobile spine is a very rare pathology, especially after 30 years of age. The clinical manifestations and radiological aspects can be confusing, which delays the diagnosis. Approximately 25% of patients present with metastatic disease at diagnosis which worsen the prognosis. In localized forms the therapeutic goal is a surgical en bloc wide resection of the tumor, a restoration of spinal column stability and avoidance of recurrence through multimodal therapy including chemotherapy and radiotherapy. We report a case of primary Ewing´s sarcoma of 12th thoracic vertebra in 30 years old man treated with chemotherapy and a double approach en bloc vertebrectomy. The reconstruction was performed with anterior bone grafting and posterior stabilization. No tumor recurrence was observed at the 3 year follow-up assessment. Imaging and clinical aspects were analyzed as well as the management modalities and outcome. Keywords: Ewing sarcoma; thoracic spine; surgery; En bloc vertebrectomy.
Primary Ewing’s sarcoma (EWS) of non-sacral spine is extremely rare,
especially in middle-age. Therapeutic strategy aims: to large tumor
resection, to provide spine stability and to avoid recurrence through
chemo and radiotherapy. We report a case of thoracic spine EWS in an
adult treated by combined approach en bloc vertebrectomy.
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